Endoscopic nasal surgery is a minimally invasive technique used to diagnose and treat a variety of conditions affecting the nose, sinuses, tear drainage system, and selected areas around the skull base and orbit. A thin endoscope with a camera is introduced through the nostrils, allowing the surgeon to clearly visualize and precisely access the affected area. Since many procedures can be performed through the natural nasal passages, external incisions may often be avoided. The exact approach and recovery depend on the condition being treated.
1. Endoscopic Sinus Surgery (FESS)
Functional Endoscopic Sinus Surgery (FESS) is commonly performed for chronic or recurrent sinusitis, nasal polyps, and sinus blockage that does not improve adequately with medical treatment. Using an endoscope, the surgeon removes obstructing tissue where required and opens the natural drainage pathways of the affected sinuses. The aim is to restore sinus ventilation and drainage while preserving healthy nasal and sinus structures as much as possible.
2. Endoscopic DCR (Dacryocystorhinostomy)
Endoscopic DCR is performed to treat obstruction of the tear drainage pathway, which may cause persistent watering of the eye, recurrent discharge, or infection of the tear sac. During the procedure, a new drainage pathway is created between the lacrimal sac and the nasal cavity using an endoscopic approach through the nose. This allows tears to drain more effectively and generally avoids an external facial incision.
3. Endoscopic Repair of CSF Leak
A cerebrospinal fluid (CSF) leak can occur when there is an abnormal opening between the space surrounding the brain and the nasal cavity, sometimes resulting in clear watery nasal discharge. Endoscopic CSF leak repair is a specialized skull-base procedure in which the site of leakage is identified and repaired through the nasal passage using appropriate grafting or sealing techniques. Accurate diagnosis and timely specialist management are important because an untreated CSF leak can increase the risk of serious complications such as meningitis.
4. Marsupialization of Nasolabial Cyst
A nasolabial cyst is a benign, fluid-filled cyst that develops in the soft tissues near the nose and upper lip. Depending on its size and location, it may cause swelling, nasal obstruction, facial discomfort, or cosmetic concerns. In selected cases, marsupialization can be performed through an intranasal endoscopic approach. The cyst is opened into the nasal cavity to establish drainage and relieve the associated symptoms while minimizing external scarring.
5. Endoscopic Optic Nerve Decompression
Endoscopic optic nerve decompression is an advanced procedure performed in carefully selected conditions where pressure on the optic nerve needs to be relieved. Using an endoscope through the nasal and sinus passages, the surgeon accesses the bony canal surrounding the optic nerve and decompresses it without a conventional external surgical approach. Because the optic nerve is a delicate structure, this procedure requires detailed evaluation and is recommended only when clinically indicated.